St Hill Catherine A, Swanoski Michael T, Lipsky Martin S, Lutfiyya May Nawal
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.
Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Minneapolis, MN 55812, USA.
Healthcare (Basel). 2017 Jul 31;5(3):39. doi: 10.3390/healthcare5030039.
In 2014, it was reported that there was a backlog of an estimated 1.2 million claims nationwide at the United States Veterans Administration (VA). This ecological occurrence opened up a space for asking and answering some important questions about health service deficits (HSD) of US veterans, which is the focus of the research reported on in this paper. The purpose of this study was to ascertain if rural veterans were more likely to experience HSDs than urban military veterans after controlling for a number of covariates. Bivariate and multivariate data analysis strategies were used to examine 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey data. HSD was the dependent variable. Two multivariate models were tested. The first logistic regression analysis yielded that rural veterans had higher odds of having at least one HSD. The second yielded that rural US veterans in 2014 who had higher odds of having at least one HSD were: 18-64 years of age, unemployed seeking employment, living in households with annual incomes lower than $75,000, without a university degree, not part of a married or unmarried couple, a current smoker, and/or a binge drinker within the last 30 days. The study described here fills identified epidemiological gaps in our knowledge regarding rural US military veterans and HSDs. The findings are not only interesting but important, and should be used to inform interventions to reduce HSDs for rural veterans.
2014年，有报道称，美国退伍军人事务部（VA）在全国范围内积压了约120万份申请。这一实际情况为提出和回答一些关于美国退伍军人医疗服务不足（HSD）的重要问题开辟了空间，这也是本文所报道研究的重点。本研究的目的是在控制若干协变量之后，确定农村退伍军人是否比城市退伍军人更有可能经历医疗服务不足。采用双变量和多变量数据分析策略，对2014年行为风险因素监测系统（BRFSS）的调查数据进行了分析。医疗服务不足是因变量。测试了两个多变量模型。第一次逻辑回归分析结果显示，农村退伍军人至少有一项医疗服务不足的几率更高。第二次分析结果显示，2014年具有至少一项医疗服务不足较高几率的美国农村退伍军人具有以下特征：年龄在18 - 64岁之间、失业且正在寻找工作、生活在年收入低于75,000美元的家庭、没有大学学位、不属于已婚或未婚伴侣、目前吸烟，和/或在过去30天内有酗酒行为。这里所描述的研究填补了我们在关于美国农村退伍军人和医疗服务不足方面已知的流行病学空白。这些发现不仅有趣而且重要，应用于为减少农村退伍军人医疗服务不足的干预措施提供依据。
